National Center for PTSD, Executive Division, White River Junction, Vermont 05009, USA.
J Womens Health (Larchmt). 2009 Oct;18(10):1549-57. doi: 10.1089/jwh.2008.1165.
This study examined dysfunctional sexual behavior and sexual concerns in women treated for posttraumatic stress disorder (PTSD). There were three objectives: to characterize the relationship between symptoms of PTSD and sexual outcomes, to examine the effect of treatment on sexual outcomes, and to examine the relationship between change in PTSD and change in sexual outcomes.
Female veterans and active duty personnel with PTSD (n = 242), 93% of whom had experienced sexual trauma, were randomly assigned to receive 10 weekly sessions of either Prolonged Exposure or Present-Centered Therapy. PTSD and sexual outcomes were assessed before and after treatment and then 3 and 6 months later.
At baseline, the reexperiencing, numbing, and hyperarousal symptom clusters were related to one or both sexual outcomes. Although prior analyses had shown that Prolonged Exposure resulted in better PTSD outcomes, there were no differences between treatments for either dysfunctional sexual behavior or sexual concerns. However, loss of PTSD diagnosis was associated with improvements in sexual concerns.
The findings suggest that clinically meaningful improvements in PTSD are necessary in order to reduce sexual problems in traumatized women.
本研究考察了创伤后应激障碍（PTSD）治疗女性的性功能障碍行为和性问题。有三个目标：描述 PTSD 症状与性结果之间的关系，检查治疗对性结果的影响，以及检查 PTSD 变化与性结果变化之间的关系。
本研究纳入了 242 名 PTSD 女性退伍军人和现役军人，其中 93%的人经历过性创伤，他们被随机分配接受 10 次每周的延长暴露或以当下为中心的治疗。在治疗前、治疗后以及 3 个月和 6 个月后评估 PTSD 和性结果。
在基线时，再体验、麻木和警觉过度症状群与一个或两个性结果有关。尽管先前的分析表明延长暴露治疗可改善 PTSD 结果，但两种治疗方法在性功能障碍行为或性问题方面均无差异。然而，PTSD 诊断的丧失与性问题的改善有关。
这些发现表明，为了减少创伤女性的性问题，需要 PTSD 有临床意义的改善。
